Southern medical journal
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Southern medical journal · Sep 2003
Parental perception of waiting time and its influence on parental satisfaction in an urban pediatric emergency department: are parents accurate in determining waiting time?
The objective of this study was to determine whether parental perception of waiting time in an urban pediatric emergency department (ED) is accurate and whether the actual waiting times or their perception of waiting times impact on parental satisfaction. ⋯ Parents tend to overestimate waiting time. Both perceived and actual waiting times that exceed 2 hours were associated with parental dissatisfaction. ED administrators may need to keep this in mind when arranging ED staffing patterns to match peak patient hours to achieve optimal parental satisfaction.
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Necrotizing fasciitis is a soft tissue infection that causes necrosis of subcutaneous tissue and fascia but usually spares skin and muscle. Management of this condition consists of early diagnosis, broad-spectrum antibiotic coverage, aggressive surgical debridement, wound closure, and intensive supportive care. Mortality estimates reported in the literature have ranged from 20 to 75%. ⋯ Complications included pneumonia, heart failure, metabolic abnormalities, anemia, and sepsis. Four (33%) of the 12 patients died, with the primary cause of death being multiorgan failure. Although our sample size is too small to reach statistical significance, the data suggest that early referral to a burn or wound care center improves patient outcome.
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Southern medical journal · Sep 2003
Parental presence during invasive procedures in children: what is the physician's perspective?
Invasive procedures may be frightening and painful experiences for children and their parents. Many parents prefer to be present when procedures are performed in their children. Allowing parents to be present during procedures decreases procedure-related anxiety. Few if any studies have addressed the physician's perspective on this issue. We conducted a simple observation survey to examine this question. ⋯ Most physicians stated that they allow parental presence during simple procedures. Physicians were more reluctant to allow parents to be present during complex procedures. EM and pediatric emergency medical training increased the physicians' level of comfort.
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Southern medical journal · Aug 2003
Case ReportsEpidural hematoma associated with dextran infusion.
The authors describe a case of epidural hematoma in association with dextran infusion in a patient who had undergone a peripheral vascular operation with epidural analgesia. Possible mechanisms for the anticoagulant effect of dextran and guidelines for the use of anticoagulant therapy in patients undergoing epidural anesthesia are discussed.
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Southern medical journal · Aug 2003
The rotating hospitalist: a solution for an academic internal medicine practice.
Concerns have been raised about the role that hospitalists may have in changing the educational process for medical students and residents, especially with regard to the primary care specialties. ⋯ Rotating hospital with office duties among a small group of internists has resulted in most of the advantages with few of the drawbacks related to the hospitalist approach.